HomeMy WebLinkAboutH2021-0358 - Permits.,+ City of Newport Beach - Building Division III III IIIIIpIII IIpIIIIII1111111p1p11111111p111 MECHANICAL Permit: H2O21-0358
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 3 5 8 Project No: 0821-2021
Permit Counter Phone (949)644-3288
'n.��zyYycff Inspection Requests Phone (949)644-3255
UNDO MECH-IN LNEBIdg:Floor: Site:
Job Address: Work:
Description of Work: MECH - INSTL NEW A/C CONDENSER. TAMPER -RESISTANT CAP REO'D.
TIMERS PROHIBITED
*NEIGHBOR LETTER ON PLAN
TIMERS
Code Edit: 2019
HEAT PUMPS
Description: EAST NEWPORT BLK A LOT 120
Owner: HONIG KEITH
Contractor:
OWNERIBLDR
Worker's Comp Insurance -
Address: 312 LINDO AVE
Address:
HONIG KEITH
Carrier :
NEWPORT BEACH, CA 92661
Policy No:
Phone: 818-515-7085
Phone:
Expire
Con State Lie: O/B
Issued Date:06/07/2021
Lie Expire:
Bus Lie:
Processed By:
Lie Exp Date:
INS1 Ri
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr: 0 $0.00
Up to 3HP: 1 $21.00
Bathroom Fan:
0
$0.00
Fire Dampers:
0 $0.00 $0.00
Over 100K BTU/hr: 0 $0.00
> 3 HP to 15 HP: 0
$0.00
Exhaust Fan:
0
$0.00
Gas Line:
0 $0.00 $0.00
Wall/Floor Heaters: 0 $0.00
>15 HP to 30 HP: 0
$0.00
Attic Fan:
0
$0.00
Metal Fireplace:
0 $0.00
Heat Pumps & Package Units
>30 HP to 50 HP 0
$0.00
Down -Draft Fan:
0
$0.00
Record Mgt Fee:
$0.00
Up to 1OOK BTU/hr: 0 $0.00
>50 HP: 0
$0.00
Residential Hood:
0
$0.00
Additional Fee:
$0.00 Investigation: $0.00
Over 500K BTU/hr: 0 $0.00
Air Handling Units
Comm. Hood:
0
$0.00
Plan Check: $18.27
Up to I BTU/hr: 0 $0.00
up to IOK CFM: 0
$0.00
Repair/Alter/Add:
0
$0.00
Model:
4TTL6036AIssuance: $37.00
Up to 1.75M BTU/hr: 0 $0.00
Over 10K CFM: 0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
TRANE
Over 1.75M BTU/hr: 0 $0.00
VAV Box: 0
$0.00
Zoning PC: $46.25
TOTAL: $122.52 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $122.62
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday -Friday 7:00 a.m. to 6:30 p.m.and Saturday from 8:00 a.m. tg 6:00 p.m.
E
C O'- � tl•
C
• •fl • i 4�f •O• i••
p(' UC •
)WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
1e permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
rofessions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
n roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
m exempt from Iicensure under the Contractors' State License Law for the following reason:
signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall,
ell structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
essions Code, is available upon request when, is applic tjo is u itted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Da
.ICENSED CONTRACTOR'S DECI O RAT
hereby affirm under penalty of perjury that I am Icensed under provis' s of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
Ind effect.
icense Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
erformance of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
rance carrier and policy number are:
Policy Number
Date
of Agent rnone s
,ee fy that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
t, if I hould become subject to the rker�s' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
ature of Applicant Date 4e. �,�01 /
CLARATION REG NG C STRUCT10hrCENDING AGENCY
areby affirm under penalty of perjury that 40 is a construction lending agency for the performance of the work for which this permit is issued (Section 3' 097, Civil Code).
ider's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and sta a laws relating to building construction.
I authorize representatives of this city or county tt enter t v 1 ified property for inspection purposes. /����
nature of Prooertv Owner or Authorized Aoent/Y �/ �-. Print Property Owners or Authorized Agent's Name/ sC �l�-l�kT L7� 10. Date L�_
ACTION DATE BY ULL-LAKAt tuiv Vr uumpLJAIYL.L VYI t r1 Luur Vr
FEDERAL REGULATIONSPART 51 OF TITLE40 AND
PERMIT EXPI RED . ` • , • • • AQMO RULE 1403.
❑ 1 SIJBMITTED ASBESTOS NORFICATION TO:
PERMITCANCELLED •.' ° : • •. • ❑ EPA
•` PERMITEXTENDED ❑ AOMD�•
ASBESTOS NOTtFICATtON IS NOT APPLICABLE TO
PERMIT FINAL p , PROPOSED DEMOLITION.
CERTIFICATEOF • .`• .•• ••• ••
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